We piled on the bus early this morning, along with Haiti Marycare and VOSH International, and started toward Jacquesyl. The clinic in the Jacquesyl countryside, frequently visited by Haiti Marycare, is a working clinic that regularly sees patients. The medical team in our group planned to set up shop there, increasing the number of patients that could be seen that day, and offering any new treatments the staff physicians may want to learn.

I headed to a nearby church with the VOSH team and Kris Beckman, a dental hygienist from Connecticut, along with her aid-for-the day Certified Medical Assistant Louise Ligas. As we approached the church, people swarmed to the bus. Eye and dental care are even rarer than medical care, and our presence filled the atmosphere with anticipation. Men from the crowd immediately helped carry the large bags of eye equipment and glasses inside, where we were greeted with hundreds of expectant eyes. Soon, the mini clinic was up and running, as more people rushed in.

Jennifer Schmidt, a nurse practitioner from Virginia,consults with a young patient and her mother at the clinic inJacquesyl.

Poor vision and eye injuries and diseases were diagnosed and treated, while infected and decayed teeth were extracted across the room. So eager to have their eyes checked, the multitude of patients gathered closer and closer, pushing and shoving, sometimes causing an uproar, as people feared they would not be seen. At several times in the day, Ralph, an interpreter from Cap Haitien, assisting the eye exams, had to break up fights over seating. “No one wants to be left out,” Ralph explained. “They don’t usually get to have something like this.”

While he was settling a group of people down, enraged over a woman cutting in line, I stopped a second to think. Something as simple as an eye exam was so precious here, it caused brawls inside the church. I couldn’t imagine going my whole life being terribly nearsighted, and waiting in line to see the world for the first time.

At the back of the church, Beckman was preparing a syringe of anesthetic to pull a decayed tooth from a local woman. “You know how much a toothache hurts,” Ligas lamented. “Imagine having completely decayed teeth for months, or years. It hurts to get it out, but you can tell they are so relieved when it’s done.”

I walked outside for a moment, after watching the tooth removed, and met a young man. He spoke a little English, and told me he was from Port-au-Prince. His family died in the earthquake, and he made it to Jacquesyl to stay with his grandmother. “My school in Port-au-Prince, it went down,” he said. “I really want to go to school in Cap Haitien, but I can’t.” I then learned that he had been treated at the clinic by our group, Jennifer Schmidt and Paige Chamlis. “We’ll be back tomorrow,” I said. “We’ll talk.” As the day came to an end, we announced we would be returning the next day, and made our way to the bus. We headed for a commune nearby, the Center for Formation, so we could start early the next day. As we drove off, smiling faces chased us, and people wearing their new sunglasses and glasses stood on their porches, waving.

CAP HAITIEN, HAITI – Gerda Birchell grew up in a very different Haiti than is known to the world today. Born in Port-au-Prince, she recalled the Haiti she once knew on the way to a makeshift clinic in Pillette Monday, to serve as an interpreter and nursing aid. “When I was 18, I remember, it was so beautiful,” she thoughtfully explained. “People came from all over to visit Haiti. Cruise ships came every day, and celebrities visited. The famous people, they had private residences here and even got married and had their honeymoons here.”

Now in her 70s, Birchell lives in Florida and is a certified nursing assistant and educator. She travels back to Haiti with her niece, Elizabeth Kaplan, a registered nurse also born in Port-au-Prince. Birchell comes to Haiti to interpret for, educate and assist those in need. Since the Jan. 12 earthquake, an “already broken Haiti is even worse,” she said. According to Birchell, much of Haiti has been in a state of devastation for many years, and the quake immensely increased the needs of the tiny Caribbean country. “It makes my heart bleed,” she said clutching her chest. “It’s very, very, very sad now. This is not the Haiti I knew.”

Gerda Birchell grew up in a very different Haiti than is known to the world today.

But Birchell has hope. Although she believes it will take “a very long time,” good changes can be made and progress instilled. “Education is the key,” she said. “We need to build more schools, so the young people can be educated and help make a difference in their own country. That was already happening a little, but it needs to increase.” Birchell says that education not only informs new generations, but increases their self-esteem and shows them how they can be effective in helping others. Only about 20 percent of the population in Haiti gets the opportunity to go to school. “They just need to be shown, and they will rise to the need,” she said.

She added that help from people from other countries, like the United States and England, is making a huge difference, and will be an important factor in rebuilding Port-au-Prince and the rest of the country. “It will be hard work and it will be long work, but I know, in my heart, that it will happen,” she said, squeezing my hand. “I will get my Haiti back.”

This morning we were joined by a group of volunteer eye doctors, known as the VOSH group, and a group from Haiti Marycare, led by Mary Lou Larkin, a pediatric nurse practitioner from Connecticut. We packed more medical supplies, along with eye exam equipment and boxes of glasses, and headed back to St. Anthony’s. Tomorrow, we would be heading to another clinic, so the goal was to help as many people today as possible in Prolonge’.

Optometrist Paul Halpern, a Pennsylvania resident, examines the eyes of a Haitian woman at St. Anthony's Clinic.

The rain had been steady last night, so our walk was longer, wetter and muddier than the day before, and we now carried more supplies. As we approached the clinic, faces from the day before surrounded us, expectant. The VOSH group set up their equipment in the building next door and immediately began examining patients for everything from eye injuries to those that simply needed glasses. Some men and women had lived their whole lives until today, unable to see, terribly nearsighted, and were elated to now be able to see the world. “He wants to thank you,” an interpreter from Haiti working with us, Emmanuel, told me, standing next to teary-eyed man wearing new glasses. I had helped the man with his vision test. “He can see now. He can work now. He can make more money for his family. They will eat well tomorrow.”

Chris Wurst, a volunteer from Pennsyvlania, hands glasses to a teenager from Prolonge at St. Anthony's Clinic.

In the clinic, the crowd was slightly less chaotic than the day before, now used to our presence. We hired men from Cap Haitien who spoke English and needed work to serve as crowd control, explaining what was happening inside. Patients from all over Haiti were seen for injuries and illness, some close to not making through the day. A baby girl, who had waited hours with her mother to be seen, was just such a patient. After being seen by Nurse Practitioner Jennifer Schmidt, it was apparent her life was in jeopardy. The Haiti Hospital appeal, which runs an ambulance, was called, and Nurse Paige Chamlis ran the baby out of the clinic and to a local man with a motorcycle to take the infant across the muddy and flooded road to meet it.

Registered Nurse Paige Chamlis, of Virginia, attempts to rehydrate a baby girl at St. Anthony's Clinic.

“A lot of times, patients who would be sent to the hospital in the U.S. we have to send on their way from the clinic, helping them the best we can,” explained Louise Ligas, a certified medical assistant. “So, if this baby had to be rushed somewhere, it was most definitely serious.” After the clinic day, the group attended a meeting of the Cap Haitien Health Network. Started by Florida-resident Dr. Ted Kaplan and wife Elizabeth, a nurse originally from Port-au-Prince, the Cap Haitien Health Network aims to make the most of medical and other groups in the area by connecting them, as well as doing their own Haiti aid. About 60 people were in attendance from groups like Clean the World, Meds and Food for Kids and Milot Hospital, as well as Food for the Poor, Haiti Hospital Appeal and VOSH. Of concern was maintaining the aid for Haitians not affected by the earthquake while also helping those that were affected. Seriously injured earthquake refugees were still pouring into the area from Port-au-Prince, adding the needy that were already here. “We need to keep everyone in mind,” Kaplan said. “There are so many more that need help, and need help now. We need to keep coming together to be the most effective.”

Kristen Rumcik, a registered nurse from Virginia, gives reconstituted hydration salts to a little boy at St. Anthony's Clinic.

Early Tuesday morning, we pooled our money together to see what medications we could purchase from a pharmacy before heading to St. Anthony’s Clinic in the Prolonge area of Cap Haitien. St. Anthony’s Clinic, built in 2008 under the donation of Virginia residents Bonnie and Mike DelBalzo, had been receiving an influx of patients from Port-au-Prince since the Jan. 12 earthquake. A large crowd was awaiting our arrival outside the small building, and an uproar ensued upon seeing us muddy and wet, carrying medical supplies.

Carrying medical supplies to St. Anthony's Clinic in Prolonge.

We immediately set up and tried to instill some level of organization, but sick and injured children and adults, desperate for care to stay alive, pushed their way through, pleading and clawing at me. I and another volunteer kept the crowd away from the tiny rooms, so patients could be treated. Children clung to my legs crying, pointing at their mouths and stomachs as I fought back my own tears, arms outstretched to block the doors. Among the chaos, Nurse Paige Chamlis was trying to fight the crowd to check everyone’s temperature, blood pressure and injuries, so the sickest would be immediately seen. “This girl has to be seen now!” she shouted above the crowd, as I held out my arm, pulling the girl through the human blockade of patients. An elderly woman, who had been standing in front of me with her granddaughter, slapped me for letting the girl through. I tried to explain to no avail – the interpreters were all busy with the doctors and nurse practitioners, where they were needed most.

Nurse Practitioner Jennifer Schmidt, who helped found St. Anthony's Clinic, checks a young patient for intestinal parasites.

A teenager, Peter, came through the crowd with his niece to help. He spoke English very well, and told the women pulling at me that the girl was very sick and needed immediate attention. “They love America, I don’t want you to think they are angry,” Peter said. “But they are worried about their families. We have seen so many people die.” I told him that I understood. Wouldn’t I do the same to save my child’s life? And I’ve been made well aware of their love and respect for the U.S. – I am approached several times a day by people wanting me to know that they love the United States. They are so appreciative of the care and donations they receive, and normally very peaceful. This continued for the rest of the day – the sick and the injured pulling at my arms and legs crying while I blocked them from the medical care they needed and ran from room to room with medications. I kept telling myself this was necessary to save lives, but I couldn’t help feeling like the evil gatekeeper, holding back the ill from their medicine.

At the end of the clinic, it was estimated that the two doctors and one nurse practitioner, being aided by nurses, had seen 150 patients. The tiny “clinic” served as a hospital – many patients, had they showed up to a doctor’s office in the U.S., would have been taken straight to a hospital’s intensive care unit. But all they had was the clinic and us.

We packed up and trudged back through the mud to our transportation. Our next stop was Justinien Hospital.

Nurse Paige Chamlis takes the temperature of a young girl.

According to Dr. Maklin Eugene, a Haitian physician who works at various clinics and hospitals throughout Cap Haitien, the hospital was also receiving a lot of patients from Port-au-Prince, some of them walking the entire 80 miles to receive care after the earthquake. Many nurses in our group, their first time on a medical trip outside the U.S., became sullen. They had put on a strong face through the chaos all day, but this hospital was too much. Injured babies in rusty cribs, limbs hanging by a thread being held together with tape and ace bandages, broken bones splinted with cardboard, surgeries being performed sometimes with little or no anesthetic. “I am trying to make it better here, but it is very hard,” Eugene explained. Just before we left the hospital, Dr. Matt Green, traveling with us from Virginia, unloaded the rest the casting supplies, splints and lidocaine he had carried with him and handed them to the nurse in the surgical center. “Thank you, thank you, thank you!” she said, thrilled with glassy eyes. We left the hospital, exhausted and emotional.

A mother using a nebulizer breathing treatment on her little girl under the care of Nurse Practitioner Jennifer Schmidt at St. Anthony's Clinic.

A baby being treated at Justinien Hospital in Cap Haitien.

A boy with a severely injured arm from Port-au-Prince being treated at Justinien Hospital.

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